Suchergebnisse

Sixty-one percent (138/226) of Swiss inpatient and outpatient alcohol treatment programmes responded to a postal survey designed to assess the definition and acceptance of controlled drinking (CD) as a treatment objective, the degree to which a client's severity of dependence and finality of CD as an outcome goal were associated with acceptance, and the perceived value of selected client characteristics when making treatment recommendations. CD was acceptable to large proportions of both outpatient services and inpatient programmes, although willingness to recommend CD was associated with client characteristics such as selecting CD as intermediate versus final outcome goal, lower severity of dependence, not being pregnant and higher social stability. Information and individual therapy to help clients pursue a CD goal are commonly available in outpatient agencies and some inpatient programmes, but group counseling, cue exposure and wet house services are not typically available from Swiss programmes.

Although drug abusers present to clinics and drop-in centers requesting various treatments and harm reduction interventions, clinicians and administrators have little direct empirical evidence of the degree to which clients find various therapies acceptable or the perceived advantages and disadvantages of specific interventions. A structured interview was administered to 48 male and female outpatient or detoxification ward clients in Nottingham, England, and 40 female residential treatment program clients in Northwest Ohio, to assess the acceptability of and related attitudes regarding a broad range of interventions. Large proportions of respondents in both samples, and especially in the English sample, reported somewhat or complete acceptance of various abstinence-oriented treatments and harm reduction interventions for those still taking drugs. Respondents also discriminated among these interventions, as evidenced by differing levels of acceptance of many and outright rejection of other interventions. Although there were differences in acceptance and experience of the specific interventions between the two samples, respondents in both countries provided balanced appraisals of the advantages and disadvantages of each intervention.

Historically, contractual agreements to control alcohol consumption have been tied to religious and temperance organizations. Recently, however, contingency contracting has been developed and investigated as a behavior therapy technique. After outlining the standard components of a contingency contract, studies investigating contingency contracting with alcohol abusers are reviewed, and clinical and ethical considerations in contracting are discussed. The research investigations show that the technique has been applied successfully with different populations of alcohol abusers and various drinking and non-drinking target behaviors. Research has also studied important aspects of the contracts themselves and has begun to recognize the role of subject characteristics in contracting. The review suggests that contracting is an effective procedure that can influence drinking and related behaviors, but this technique is relatively new and more research is needed about its most effective components and the most applicable target behaviors.